Simple roller-pump based trans-apical left ventricular assist (TALVB) devices developed by Dr. Jeffrey Peters (Univ. of Utah) and Dr. Kazumi Taguchi (University of Hiroshima) will be clinically implemented in a carefully characterized population of patients for whom there is presently no other hope. Whether or not the failing heart recovers, and how, will be assessed with a variety of techniques including phased-array echo cardiography, radionuclide angiography. The effects on blood and other organ systems will also be assessed. Patients who cannot be weaned from the device, but are otherwise suitable for cardiac transplantation, will be offered such therapy. If these simple devices prove practical and effective, protocols and programs will be developed to expedite implementation at other institutions.